The significance of pseudoaneurysms in the nonoperative management of pediatric blunt splenic trauma

Martin, Kathryn; VanHouwelingen, Lisa; Bütter, Andreana

doi:10.1016/j.jpedsurg.2011.02.031

Cited by 40 publications

(33 citation statements)

References 37 publications

(101 reference statements)

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“…10,11 The median splenic grade of injury in the TAE group was 4, similar to the adult literature, where most patients requiring TAE have a high-grade injury. 6 Interestingly, only one of our TAE patients did not have an isolated splenic injury or minimal associated injuries (median ISS, 16). As such, we were unable to assess the relationship between ISS and the use of TAE.…”

Section: Discussionmentioning

confidence: 93%

“…Although routine screening for pseudoaneurysms was previously recommended by Safavi et al, 15 Martin et al, 16 in 2011, published a systematic review of the medical literature and concluded that there is no evidence to support or refute routine screening for splenic pseudoaneurysms following BSIs. We do not screen routinely for the presence of splenic pseudoaneurysms regardless of grade of injury, and it is possible that other non-TAE patients may have had an undiagnosed splenic artery pseudoaneurysm.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transarterial embolization in children with blunt splenic injury results in postembolization syndrome

Ben-Ishay

Gutierrez

Pennington

et al. 2012

Journal of Trauma and Acute Care Surgery

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Transarterial embolization in children with blunt splenic injury results in postembolization syndrome

Ben-Ishay

Gutierrez

Pennington

et al. 2012

Journal of Trauma and Acute Care Surgery

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“…These patients had a high rate of intervention (75%) but a low rate of symptoms 11%. 44 Currently, there are no prospective studies in children to direct management of posttraumatic SAP or HAP.…”

Section: Angioembolizationmentioning

confidence: 99%

“…While a recent prospective trial of 199 pediatric found no complications at 10 week posthospital, 26 there have been reports of spontaneous rupture of SAP and HAP in the pediatric population. 43,44 We do not currently perform any routine in-hospital or postdischarge imaging in the absence of symptoms.…”

Section: Follow-upmentioning

confidence: 99%

Blunt Spleen and Liver Trauma

Dalton

Dehmer

Gonzalez

et al. 2015

J Pediatr Intensive Care

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Blunt abdominal trauma is an important cause of pediatric morbidity and mortality. The spleen and liver are the most common abdominal organs injured. Trauma to either organ can result in life-threatening bleeding. Controversy exists regarding which patients should be imaged and the correct imaging modality depending on the level of clinical suspicion for injury. Nonoperative management of blunt abdominal trauma is the standard of care for hemodynamically stable patients. However, the optimal protocol to maximize patient safety while minimizing resource utilization is a matter of debate. Adjunctive therapies for pediatric spleen and liver trauma are also an area of ongoing research. A review of the current literature on the diagnosis, management, and follow-up of pediatric spleen and liver blunt trauma is presented.

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“…In the McVay article, they recommended ultrasound to allow earlier discharge, but since no interventions resulted from their follow-up imaging, this argument for routine reimaging now falls short. Martin et al performed a meta-analysis of pseudoaneurysms and the utility of reimaging was found inconclusive [18]. In final analysis, the APSA guidelines recommending no routine reimaging is clearly valid, but current recommendations for high grade liver imagines are less clear.…”

Section: Utility Of Reimagingmentioning

confidence: 99%